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Perioperative Use of Intravenous Lidocaine


Bottom line: This article explains how lidocaine has the prolonged effect of reported benefits of reduction in pain, nausea, ileus duration, opioid requirement, and length of stay despite low blood concentrations of lidocaine. It also reviews the surgeries in which the benefit of perioperative lidocaine infusion has been established. 

Major points

1. Some of the pro-inflammatory effects of surgery that contribute to postoperative complications may be attenuated by lidocaine by the local anesthetics ability to block priming of PMN's at very low doses. 

2. Perioperative lidocaine infusion may be beneficial for open and laparoscopic abdominal procedures, radical prostatectomy, mastectomy, thoracic, major spine surgery

3. There may be less benefit in patients undergoing laparoscopic renal surgery, obstetric patients, total abdominal hysterectomy, cardiac surgery, hip surgery

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